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跨导管干预期间患者辐射剂量的机构变化:全州的经验

David A McNamara¹, Jeremy Albright², Devraj Sukul²

¹Frederik Meijer Heart & Vascular Institute, Corewell Health West, Grand Rapids, Michigan, USA.

JACC. Cardiovascular interventions

|October 25, 2024

概括

跨导管干预期间的辐射剂量因机构而异. 执行医院,而不是患者因素,是高辐射暴露 (≥2 Gy) 的最强有力的预测因素.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
放射学放射学是一门学科.

背景情况:

对于跨导管干预的机构辐射剂量存在有限的数据.
了解辐射暴露对于这些程序中的患者安全至关重要.

研究的目的:

为了评估在跨导管干预期间辐射剂量的机构变异性.
在这些程序中识别与较高辐射剂量相关的因素.

主要方法:

分析一个大型全州注册表的跨导管边缘到边缘的中枢门修复,跨导管中枢门更换和跨导管大动脉门更换程序 (2020-2022年).
患者和程序特征的比较,空气基因 (AK) ≥2 Gy与<2 Gy的病例.
贝叶斯随机效应建模,以评估AK ≥2 Gy的关联,重点关注执行医院.

主要成果:

分析了30家医院的9446项手术;中位数的手术AK为0.592 Gy.
5.6%的病例具有AK≥2 Gy,机构频率从0.0%到29.5%不等.
执行医院是AK≥2 Gy (中位数OR:3.54) 的最强预测因素,超过了患者或程序因素.

结论:

在跨导管干预期间,患者水平的辐射剂量存在显著的机构变化.
执行医院是高辐射暴露的关键决定因素,而不是患者或程序特征.
需要采取干预措施来规范和减少过程性辐射暴露变化.

关键词:

在TAVRR中,我们可以看到.在这里,Teer Teer.这是一个TMVR.职业辐射职业辐射辐射安全辐射安全通过导管更换大动脉门.穿透管端到端的 mitra 门维修通过透气管来更换米特拉.

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